Regenerative Approaches Using Platelet-Rich Plasma (PRP) and Stem Cells for Pelvic Floor Disorders: A Systematic Review

Devanti Octavia Ellyamurti (Department of Medicine, Faculty of Medicine, Universitas Trisakti)
Griffin Mia Inggita Kusno (UIN Syarif Hidayatullah Jakarta)
Tuti Khairani Rahman (Universitas Islam Sumatera Utara)
Putri Dhiya Prameswari Woyono (Department of Obstetrics and Gynecology, RSIA Kasih Fatimah Kotamobagu)

Medicinus : Jurnal Kedokteran
Vol. 15 No. 3 (2026): June

Background: Pelvic floor disorders, including stress urinary incontinence, pelvic organ prolapse, fecal incontinence, and vulvovaginal atrophy, represent a major burden on quality of life. Platelet-rich plasma and platelet-rich fibrin have emerged as autologous regenerative therapies with potential applications across these conditions. This systematic review synthesized the clinical evidence from human trials of platelet-rich plasma and platelet-rich fibrin for pelvic floor disorders to evaluate efficacy, safety, and methodological quality. Methods: PubMed, EMBASE, and Scopus were searched from inception through 15 May 2026. Eligible studies were human clinical trials of platelet-rich plasma or platelet-rich fibrin injection for pelvic floor disorders or closely related urogynecologic conditions reporting continence, functional, quality-of-life, or safety outcomes. Study selection was performed independently by all authors, with discrepancies resolved through discussion. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool for randomized trials and the Risk of Bias in Non-Randomized Studies of Interventions tool for observational studies. Result: Fourteen studies (663 participants) were included, comprising six randomized trials and eight prospective nonrandomized or single-arm studies. The majority addressed female stress urinary incontinence. Randomized controlled trials demonstrated significant improvements in continence questionnaires and pad tests favoring platelet-rich plasma over sham or pelvic floor muscle training. However, one placebo-controlled trial found no significant difference. Safety profiles were favorable across all studies. Risk of bias was high in single-arm studies and ranged from some concerns to low in randomized trials. Conclusions: Platelet-rich plasma and platelet-rich fibrin demonstrate preliminary safety and efficacy signals for pelvic floor disorders, particularly stress urinary incontinence. However, the evidence base remains limited by small sample sizes, heterogeneous protocols, and a predominance of uncontrolled studies, warranting larger, well-designed randomized controlled trials.